Cartridge assemblies for surgical staplers

ABSTRACT

Surgical stapling devices are disclosed herein that improve on the disclosures of previous surgical stapling devices.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 16/727,160, entitledCARTRIDGE ASSEMBLIES FOR SURGICAL STAPLERS, filed Dec. 26, 2019, nowU.S. Patent Application Publication No. 2020/0222047, which is adivisional application claiming priority under 35 U.S.C. § 121 to U.S.patent application Ser. No. 14/527,384, entitled CARTRIDGE ASSEMBLIESFOR SURGICAL STAPLERS, filed Oct. 29, 2014, which issued on Dec. 31,2019 as U.S. Pat. No. 10,517,594, the entire disclosures of which ishereby incorporated by reference herein.

BACKGROUND

The present invention relates to stapling instruments and, in variousembodiments, to a surgical stapling instrument for producing one or morerows of staples.

A stapling instrument can include a pair of cooperating elongate jawmembers, wherein each jaw member can be adapted to be inserted into apatient and positioned relative to tissue that is to be stapled and/orincised. In various embodiments, one of the jaw members can support astaple cartridge with at least two laterally spaced rows of staplescontained therein, and the other jaw member can support an anvil withstaple-forming pockets aligned with the rows of staples in the staplecartridge. Generally, the stapling instrument can further include apusher bar and a knife blade which are slidable relative to the jawmembers to sequentially eject the staples from the staple cartridge viacamming surfaces on the pusher bar and/or camming surfaces on a wedgesled that is pushed by the pusher bar. In at least one embodiment, thecamming surfaces can be configured to activate a plurality of stapledrivers carried by the cartridge and associated with the staples inorder to push the staples against the anvil and form laterally spacedrows of deformed staples in the tissue gripped between the jaw members.In at least one embodiment, the knife blade can trail the cammingsurfaces and cut the tissue along a line between the staple rows.Examples of such stapling instruments are disclosed in U.S. Pat. No.7,794,475, entitled SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLEMEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FORDEPLOYING THE SAME, the entire disclosure of which is herebyincorporated by reference herein.

BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein are set forth withparticularity in the appended claims. The various embodiments, however,both as to organization and methods of operation, together withadvantages thereof, may be understood in accordance with the followingdescription taken in conjunction with the accompanying drawings asfollows:

FIG. 1 is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 1A is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 1B is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 1C is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 1D is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 1E is a perspective view of a staple drive assembly showing anactuation sled and a staple pusher system in accordance with at leastone embodiment;

FIG. 2 is a perspective view of a surgical stapling apparatus inaccordance with at least one embodiment;

FIG. 2A is a side elevational view of an alternative end effector of thesurgical stapling apparatus of FIG. 2 in accordance with at least oneembodiment;

FIG. 2B is a side elevational view of the end effector FIG. 2A in apartially open configuration;

FIG. 2C is a perspective view of an end effector of the surgicalstapling apparatus of FIG. 2 in accordance with at least one embodiment;

FIG. 2D is a cross sectional view of the end effector of FIG. 2C in aclosed configuration in accordance with at least one embodiment;

FIG. 3 is an exploded perspective view of a staple cartridge, staples,staple pushers, and an actuation sled in accordance with at least oneembodiment;

FIG. 3A is an exploded perspective view of a staple cartridge, staples,and staple pushers in accordance with at least one embodiment;

FIG. 3B is a side perspective view of staples and a staple pusher inaccordance with at least one embodiment;

FIG. 3C is a side elevational view of a “V” shaped staple in accordancewith at least one embodiment;

FIG. 3D is a side elevational view of a “U” shaped staple in accordancewith at least one embodiment;

FIG. 3E is a perspective view of a “U” shaped staple positioned onto astaple pusher plate in accordance with at least one embodiment;

FIG. 3F is a perspective view of a “U” shaped staple positioned onto astaple pusher plate in accordance with at least one embodiment;

FIG. 3G is a partial cross-sectional view of a “U” shaped staple and thestaple pusher plate before the “U” shaped staple is positioned onto thestaple pusher plate;

FIG. 3H is a partial cross-sectional view of the “U” shaped staple andthe staple pusher plate of FIG. 3G while the “U” shaped staple ispositioned onto the staple pusher plate;

FIG. 3I is a partial perspective view of a staple deposited in aretention slot in accordance with at least one embodiment;

FIG. 3J is a partial cross-sectional view of along the line 3J-3J ofFIG. 3I;

FIG. 4 is a top plan view of the staple cartridge of FIG. 3 with theactuation sled in an initial position;

FIG. 5 is a side cross-sectional view of a proximal portion of thestaple cartridge taken along section line 5-5 of FIG. 4 ;

FIG. 6 is a front perspective view of the staple pusher of FIG. 1 ;

FIG. 7 is a rear perspective view of the staple pusher of FIG. 1 ;

FIG. 8 is a top plan view of the staple pusher of FIG. 1 ;

FIG. 9 is a side cross-sectional view taken along section line 9-9 ofFIG. 8 ;

FIG. 10 is a side cross-sectional view taken along section line 10-10 ofFIG. 8 ;

FIG. 11 is a front perspective view of the actuation sled of FIG. 1 ;

FIG. 12 is a rear perspective view of the actuation sled of FIG. 1 ;

FIG. 13 is a top plan view of the actuation sled of FIG. 1 ;

FIG. 14 is a side cross-sectional view taken along section line 14-14 ofFIG. 13 ;

FIG. 15 is a side cross-sectional view taken along section line 15-15 ofFIG. 13 ;

FIG. 16 is a side cross-sectional view of the staple drive assembly ofFIG. 1 showing the initial engagement between the cam members of thestaple pusher of FIG. 6 and the cam wedges of the actuation sled as theactuation sled moves in the direction of arrow A;

FIG. 17 is a side cross-sectional view of the staple drive assembly ofFIG. 1 showing the continued engagement between the cam members of thestaple pusher of FIG. 6 and the cam wedges of the actuation sled as theactuation sled continues to move in the direction of arrow A; and

FIG. 18 is a top plan view taken along section line 18-18 in FIG. 17 ofthe staple drive assembly of FIG. 17 .

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate various embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Applicant of the present application owns the following patentapplication which was filed on Oct. 29, 2014 and which is hereinincorporated by reference in its entirety:

U.S. patent application Ser. No. 14/527,398, entitled STAPLE CARTRIDGESCOMPRISING DRIVER ARRANGEMENTS, now U.S. Patent Application PublicationNo. 2016/0120545.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. It will be understood by those skilled in theart, however, that the embodiments may be practiced without suchspecific details. In other instances, well-known operations, components,and elements have not been described in detail so as not to obscure theembodiments described in the specification. Those of ordinary skill inthe art will understand that the embodiments described and illustratedherein are non-limiting examples, and thus it can be appreciated thatthe specific structural and functional details disclosed herein may berepresentative and illustrative. Variations and changes thereto may bemade without departing from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes” or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes” or “contains” one or more features possesses those oneor more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” referring to the portion closest to the clinicianand the term “distal” referring to the portion located away from theclinician. It will be further appreciated that, for convenience andclarity, spatial terms such as “vertical”, “horizontal”, “up”, and“down” may be used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, theperson of ordinary skill in the art will readily appreciate that thevarious methods and devices disclosed herein can be used in numeroussurgical procedures and applications including, for example, inconnection with open surgical procedures. As the present DetailedDescription proceeds, those of ordinary skill in the art will furtherappreciate that the various instruments disclosed herein can be insertedinto a body in any way, such as through a natural orifice, through anincision or puncture hole formed in tissue, etc. The working portions orend effector portions of the instruments can be inserted directly into apatient's body or can be inserted through an access device that has aworking channel through which the end effector and elongated shaft of asurgical instrument can be advanced.

The present disclosure is directed toward a staple drive assembly foruse in a staple cartridge. The staple drive assembly may also be used ina disposable loading unit and/or any other suitable device and can beconfigured to deploy numerous types of staples and/or fasteners. Thestaple drive assembly includes an actuation sled and at least one stapledriver. The staple cartridge includes a tissue contacting and/orsupporting surface having a number of staple cavities wherein eachstaple cavity is adapted for releasably receiving a staple. The staplecartridge may include a guide channel / knife slot extending from aproximal portion to a distal portion along its longitudinal axis. In oneembodiment, the staple cartridge is adapted for use in a surgicalstapler having a drive mechanism.

An example of a surgical stapler having a staple drive assembly isdisclosed in U.S. Pat. No. 6,669,073, entitled SURGICAL STAPLINGAPPARATUS, which issued on Dec. 30, 2003, the entire disclosure of whichis incorporated herein by reference. The disclosures of U.S. Pat. No.7,866,528, entitled STAPLE DRIVE ASSEMBLY, filed Jan. 11, 2011 and U.S.Patent Application Publication No. 2013/0327810, entitled FASTENERCARTRIDGE ASSEMBLY COMPRISING A FIXED ANVIL AND A STAPLE DRIVERARRANGEMENT, filed Aug. 15, 2013, now U.S. Pat. No. 9,839,427, are alsohereby incorporated by reference herein in their entireties.

A staple drive assembly 100, in accordance with one embodiment of thepresent disclosure, is illustrated in FIG. 1 . The staple drive assembly100 includes an actuation sled 110 and at least one staple pusherarrangement or system 160. The actuation sled 110 includes a base 112, afirst camming member 120, a second camming member 140, and a guidemember 150. The first and second camming members 120 and 140 includerespective first or leading cam wedges 122 and 142 and respective secondor trailing cam wedges 124 and 144. In one embodiment, staple driveassembly 100 is adapted for use in a surgical stapler having at leasttwo linear rows of staples such as an endoscopic or laparoscopicstapler.

Referring to FIG. 2 , a surgical stapler 10 is shown. The surgicalstapler 10 includes a trigger assembly 30, a body portion 12, a staplecartridge 40, and an anvil assembly 70. Trigger assembly 30 includes apivotal trigger 32. Pivotal movement of the trigger 32 during anactuation sequence of the trigger 32 translates pivotal movement of thetrigger 32 into linear movement of a drive mechanism (not shown). Thedrive mechanism is operatively coupled to an actuation sled in thestaple cartridge 40 to translate linear movement of the drive mechanismto linear movement of the actuation sled. The surgical stapler 10 ismovable such that a portion of body tissue (not shown) may be positionedbetween the anvil assembly 70 and the staple cartridge 40. Actuation ofstapler 10 moves anvil assembly 70 towards staple cartridge 40 therebygrasping or retaining the portion of body tissue therebetween. Inaddition, once the portion of body tissue is grasped between the anvilassembly 70 and the staple cartridge 40, continued actuation of stapler10 discharges staples 50 (FIG. 3 ) through the portion of body tissueand against the anvil assembly 70 to form completed staples 50.

A staple drive assembly such as, for example, the staple drive assembly100 (FIG. 1 ), the staple drive assembly 200 (FIG. 1A), the staple driveassembly 300 (FIG. 1B), the staple drive assembly 400 (FIG. 1C), thestaple drive assembly 700 (FIG. 1D), the staple drive assembly 800 (FIG.1E) may be incorporated into the staple cartridge 40 of surgical stapler10. Alternately, the staple drive assembly 100, 200, 300, 400, 700,and/or 800 may be incorporated into other known stapling devicesincluding open-type surgical stapling devices and other endoscopic orlaparoscopic surgical stapling devices, for example. While the presentdisclosure describes embodiments involving an actuation sled, it alsowill be appreciated that the design characteristics and function of thesled camming members may be incorporated directly into cam bars orfiring wedges, which in turn are connected to the firing mechanism ofthe surgical stapling instrument.

FIG. 3 illustrates a staple cartridge 40′ including the staple driveassembly 100. The staple cartridge 40′ includes a plurality of fastenersor staples 50 and a corresponding number of staple pockets or retentionslots 60. A tissue contacting and/or supporting surface 44 is defined bya top surface of the staple cartridge 40′. A guide channel 42 extendssubstantially the length of staple cartridge 40′ and is adapted forslidably receiving guide member 150 of actuation sled 110 as shown inFIG. 4 . In FIG. 4 , sled 110 is shown positioned at the proximal end ofthe staple cartridge 40′ with the guide member 150 disposed in the guidechannel 42. The guide channel 42 cooperates with the guide member 150for aligning and positioning the actuation sled 110 in the staplecartridge 40′ as it translates longitudinally from a proximal end to adistal end of the staple cartridge 40′. Guide channel 42 may alsofacilitate passage of a knife blade (not shown) through the staplecartridge 40′. In various instances, a knife blade can be mounted to theguide member 150.

In FIG. 5 , which is a cross-sectional view taken along line 5-5 of FIG.4 , the actuation sled 110 is shown disposed in the proximal end ofstaple cartridge 40′ in a first or ready position, for example. In theready position, the actuation sled 110 is capable of translatingdistally through the staple cartridge 40′, in the direction indicated byarrow A, and sequentially engaging the staple pushers 160 (FIG. 3 ). Theactuation sled 110 is translatable along a longitudinal axis of thestaple cartridge 40′ from its ready position to a second or end positionlocated in a distal portion of the staple cartridge 40′.

As previously discussed, the staple pusher 160 includes prongs or pusherplates 166 that are laterally and longitudinally spaced apart as well asfirst and second cam members 162, 164 interposed between adjacent pusherplates 166. More specifically, as discussed hereinabove, in oneembodiment of the present disclosure, each staple pusher 160 includes aplurality of independent pusher plates 166 that are substantiallyparallel to a longitudinal axis of staple cartridge 40′ and parallel toa centerline CL of each staple pusher 160 (FIG. 8 ). Additionally, firstand second cam members or portions162, 164 are also substantiallyparallel to centerline CL (FIG. 8 ).

Staple pusher 160, as viewed from left to right in FIG. 8 (i.e. distalto proximal), includes an inboard pusher plate 166 that is most distalalong centerline CL. A middle pusher plate 166 is laterally spaced apartfrom inboard pusher plate 166 and is axially offset in the proximaldirection from inboard pusher plate 166. An outboard pusher plate 166 islaterally spaced apart from middle pusher plate 166 and is axiallyoffset in the proximal direction from middle pusher plate 166. Furtherstill, first cam member 162 is disposed between inboard pusher plate 166and middle pusher plate 166 while second cam member 164 is disposedbetween middle pusher plate 166 and outboard pusher plate 166.Configured thusly, staple pusher 160 has an arrangement where pusherplates 166 are longitudinally staggered from a distal portion of staplepusher 160 to a proximal portion of staple pusher 160 as seen in FIG. 8. An outboard pusher plate 166 is closer to a distal portion of a staplecartridge that incorporates the staple pusher 160 than a middle pusherplate 166 and the middle pusher plate 166 is closer to the distalportion of the staple cartridge than the inboard pusher plate 166, forexample.

First and second cam members 162, 164 include respective first andsecond cam surfaces 162 a, 162 b, and 164 a, 164 b (FIGS. 9 and 10 ). Atthe intersection of first and second cam surfaces 162 a, 162 b and 164a, 164 b are respective transition points 162 c, 164 c. A plane T (FIG.10 ) extending through transition points 162 c, 164 c is parallel torespective tops 163, 165 of cam members 162, 164. In one embodiment,first cam surfaces 162 a, 164 a define a first engagement or receivingangle with respect to tops 163, 165 of respective first and second cammembers 162, 164. Second cam surfaces 162 b, 164 b define a secondengagement or receiving angle with respect to plane T. First and secondreceiving angles are complementary to respective first and second driveangles of camming members 120, 140 of actuation sled 110.

With reference to FIGS. 11-15 , several views of one embodiment ofactuation sled 110 are shown. First and second camming members 120, 140each include a first or leading cam wedge 122, 142, respectively, thatis laterally and longitudinally spaced apart from a second or trailingcam wedge 124, 144, respectively. The lateral and longitudinal offsetdistances of each pair of camming wedges substantially corresponds tothe lateral and longitudinal offset distances between corresponding cammembers 162, 164. First cam wedges 122, 142 are laterally andlongitudinally spaced from second cam wedges 124, 144, respectively, bya substantially identical amount such that first and second cammingmembers 120, 140 are symmetrical about a central longitudinal axis ofactuation sled 110. Leading cam wedges 122, 142 include respective firstand second drive faces 122 a, 122 b, 142 a, and 142 b. First drive faces122 a, 142 a form first drive angles on camming members 120, 140 withrespect to base 112 of actuation sled 110. At the intersection of firstand second drive faces 122 a, 142 a and 122 b, 142 b are respectivetransition points 123, 143. A plane X extending through transitionpoints 123, 143 is substantially parallel to base 112. Second drivefaces 122 b, 142 b form respective second drive angles on cammingmembers 120, 140 with respect to plane X. Plane X is also substantiallyparallel to tissue contacting surface 44 of staple cartridge 40′.

Similarly, trailing cam wedges 124, 144 include respective first andsecond drive faces 124 a, 124 b, 144 a, and 144 b. First drive faces 124a, 144 a form first drive angles on camming members 120, 140 withrespect to base 112 (FIG. 5 ) of actuation sled 110. At the intersectionof first and second drive faces 124 a, 124 b and 144 a, 144 b arerespective transition points 125, 145. Plane X extends throughtransition points 125, 145 and is substantially parallel to base 112.Second drive faces 124 b, 144 b form respective second drive angles oncamming members 120, 140 with respect to plane X.

Interaction between the actuation sled 110 and the staple pusher 160 ofthe staple drive assembly 100 is shown in FIGS. 16-18 and discussed indetail hereinafter. The interactions between actuation sleds of otherstaple drive assemblies described hereinafter and their correspondingstaple pushers can be the same or, or at least similar, in many respectsto the interaction between the actuation sled 110 and the staple pusher160. Accordingly, for the sake of brevity, the detailed description ofsuch interactions is omitted.

Initially, as illustrated in FIG. 16 , actuation sled 110 translatesdistally through staple cartridge 40′ in the direction indicated byarrow A (see also FIG. 5 ) causing first drive face 122 a to slidablyengage first cam surface 162 a and urge staple pusher 160 from its firstor rest position in a generally vertical direction as indicated by arrowB. Because the lateral and longitudinal offset distances of wedges 122,124 correspond to the lateral and longitudinal offset distances betweencam wedges 162, 164, first drive face 124 a substantially simultaneouslyslidably engages first cam surface 164 a thereby urging staple pusher160 in a generally vertical direction as indicated by arrow B. Since camsurfaces 162 a and 164 a are longitudinally offset, staple pusher 160 isdriven in a controlled and balanced manner and any tendency of staplepusher 160 to tilt or rotate counterclockwise (as viewed in FIGS. 16-17) is minimized as staple pusher 160 is driven through retainer slot 60.First drive faces 122 a, 124 a and respective first cam surfaces 162 a,164 a have complementary angles that maximize translation oflongitudinal motion of actuation sled 110 to vertical motion of staplepusher 160.

Referring now to FIG. 17 , continued distal movement of actuation sled110 further urges staple pusher 160 generally vertically to anintermediate position, such that second drive faces 122 b, 124 bslidably engage respective second cam surfaces 162 b, 164 b while firstdrive faces 122 a, 124 a substantially simultaneously disengage fromrespective first cam surfaces 162 a, 164 a. Similarly, second drivefaces 122 b, 124 b and respective second cam surfaces 162 b, 164 b havecomplementary angles to maximize translation of longitudinal motion ofactuation sled 110 to vertical motion of staple pusher 160. Thecorresponding lateral and longitudinal offset of second drive faces 122b, 124 b and respective second cam surfaces 162 b, 164 b continue tocontrol the advancement of staple pusher 160 so as to minimize anytendency of staple pusher 160 to tilt or rotate in a counterclockwisedirection as viewed in FIGS. 16 and 17 . Continuing distal movement ofactuation sled 110 continues to urge staple pusher 160 vertically to itssecond or end position immediately prior to the disengagement betweensecond drive faces 122 b, 124 b and respective second cam surfaces 162b, 164 b.

Further to the above, longitudinal motion of actuation sled 110 in thedirection indicated by arrow A results in first and second cammingmembers 120, 140 slidably engaging staple pushers 160 as shown in FIGS.16-18 . Sliding engagement between leading cam wedges 122, 142 and firstcam members 162 in cooperation with the substantially simultaneousengagement between trailing cam wedges 124, 144 and second cam members164 improve the longitudinal stability of the staple pushers 160 duringvertical motion as follows. Leading cam wedges 122, 142 arelongitudinally spaced apart from trailing cam wedges 124, 144 by apredetermined amount. Since respective first and second cam members 162,164 are longitudinally spaced apart by a comparable, but complementaryamount, longitudinal movement of actuation sled 110 results in thesubstantially simultaneous, but offset engagement of leading cam wedges122, 124 and trailing cam wedges 124, 144 with respective first andsecond cam members 162, 164 thereby transferring the longitudinalmovement of actuation sled 110 to vertical movement of staple pusher 160at longitudinally spaced apart impact points.

Referring to FIG. 3A, a staple cartridge 2140 includes a tissuecontacting and/or supporting portion 2161. The tissue contacting portion2161 includes three tissue contacting and/or supporting surfaces 2161a-2161 c. Tissue contacting surfaces 2161 a-2161 c are planar, or atleast substantially planar, structures that are substantially parallelto one another, but are not co-planar with one another. Said anotherway, the tissue contacting portion 2161 is stepped. A set of tissuecontacting surfaces 2161 a-2161 c is disposed on each side of a knifechannel 2148. The tissue contacting surfaces 2161 c have a knife channel2148 defined therebetween. The tissue contacting surfaces 2161 c areco-planar with one another. The tissue contacting surfaces 2161 a-2161 cinclude different heights as measured from a datum such as the placeincluding the top of the knife channel 2148, for example. Additionally,the tissue contacting surfaces 2161 a on opposite sides of the knifechannel 2148 are co-planar with one another. Similarly, the tissuecontacting surfaces 2161 b on opposite sides of the knife channel 2148are co-planar with one another. Furthermore, the tissue contactingsurfaces 2161 c on opposite sides of the knife channel 2148 areco-planar with one another. Although the drawings show planar tissuecontacting surfaces 2161 a-2161 c, the present disclosure envisionscurved or angled tissue contacting surfaces as well as other kinds oftissue contacting surfaces having other shapes and structures.

A wall or any other suitable structure interconnects the tissuecontacting surfaces 2161 a and 2161 b. Similarly, a suitable structuresuch as a wall interconnects the tissue contacting surfaces 2161 b and2161 c. The walls or interconnecting structures may be orientedorthogonally with respect to the tissue contacting surfaces 2161 a-2161c. The present disclosure, however, contemplates walls orinterconnecting structures oriented in different directions such asangled, curved or other configurations.

In certain instances, referring to FIG. 3A, the tissue contactingsurface 2161 c has a height greater than the tissue contacting surface2161 b; and the tissue contacting surface 2161 b has a height greaterthan the tissue contacting surface 2161 a. While tissue contactingsurfaces 2161 a-2161 c are shown as decreasing in height between thefirst tissue contacting surface 2161 a and the third tissue contactingsurface 2161 c, it is envisioned that the heights of each tissuecontacting surface may vary depending on the particular surgicalprocedure. Other features of tissue contacting surfaces 2161 a-2161 cmay also vary according to the circumstances.

Each tissue contacting surface 2161 a-2161 c includes a plurality ofretention slots 2144 formed therein. Retention slots 2144 are disposedin a plurality of rows 2144 a, 2144 b, and 2144 c that are located intissue contacting surfaces 2161 a, 2161 b, and 2161 c, respectively. Thelinear rows of retention slots 2144 a-2144 c are staggered along thelongitudinal axis of staple cartridge 2140 as shown in FIG. 3A.Particularly, the distal most retention slots 2144 of rows 2144 a, 2144c are closer to a distal end of the staple cartridge 2140 than thedistal most retention slots 2144 of row 2144 b. On the other hand, themost proximal retention slots 2144 of rows 2144 b are closer to theproximal end of cartridge 2140 than the most proximal retention slots2144 of rows 2144 a and 2144 c. Linear rows of retention slots 2144a-2144 c having other suitable arrangements are within the scope of thepresent disclosure as long as they are capable of receiving surgicalfasteners.

In certain instances, as illustrated in FIG. 3A, the retention slots ofthe row of retention slots 2144 a are positioned at regular intervalsalong a first longitudinal axis. Spaces between adjacent retention slotsof the row of retention slots 2144 a can be referred to as staple gapsin the first longitudinal axis as tissue positioned over such spaceswill not be stapled by staples ejected from the retention slots of therow of retention slots 2144 a. The retention slots of the row ofretention slots 2144 b are also positioned at regular intervals along asecond longitudinal axis. The retention slots of the row of retentionslots 2144 b are staggered with respect to the retention slots of therow of retention slots 2144 a. The retention slots of the row ofretention slots 2144 b are positioned laterally with respect to thestaple gaps in the row of retention slots 2144 a. Spaces betweenadjacent retention slots of the row of retention slots 2144 b can alsobe referred to as staple gaps in the second longitudinal axis as tissuepositioned over such spaces will not be stapled by staples ejected fromthe retention slots of the row of retention slots 2144 b. The retentionslots of the row of retention slots 2144 c are also positioned atregular intervals along a third longitudinal axis. The retention slotsof the row of retention slots 2144 c are staggered with respect to theretention slots of the row of retention slots 2144 b. The retentionslots of the row of retention slots 2144 c are positioned laterally withrespect to the staple gaps in the retention slots of the row ofretention slots 2144 b.

FIG. 3B illustrates an arrangement of the surgical fasteners 50 a-50 cin the staple cartridge 2140. Staple cartridge 2140 includes surgicalfasteners or staples 50 a, 50 b, and 50 c. Each staple 50 a, 50 b, and50 c includes a base 52 a-52 c. Legs 55 a of the surgical fasteners 50 ahave a first leg length “A”, legs 55 b of the surgical fasteners 50 bhave a second leg length “B”, and legs 55 c of surgical fasteners 50 chave a third leg length “C.” In one embodiment, the first length “A” isgreater than the second length “B.” In turn, the second length “B” isgreater than the third length “C.” Surgical fasteners 50 a-50 c areconfigured to operate in conjunction with staple pusher 2160.

Surgical fasteners 50 a-50 c cooperate with staple pusher 2160 and sled110 such that the longitudinal translation of sled 110 through staplecartridge 2140 urges pushers 2160 in a vertical direction to eject thesurgical fasteners 50 a-50 c. As shown in FIG. 3B, the staple pusher2160 includes pusher plates 2166 a-2166 c, each of which has a differentvertical dimension. Pusher plate 2166 c has the greatest verticaldimension and cooperates with the surgical fastener 50 c, which has thesmallest leg length. Pusher plate 2166 a has the smallest verticaldimension and cooperates with the surgical fastener 50 a, which has thelargest leg length. Pusher plate 2166 b has a vertical dimension greaterthan pusher plate 2166 a, but less than pusher plate 2166 c andcooperates with surgical fastener 50 b, which has an intermediate leglength, between those of the surgical fasteners 50 a and 50 c. Thesurgical fasteners 50 c are arranged adjacent the knife channel 2148.Surgical fasteners 50 a are adjacent to an outer edge of the staplecartridge 2140, and surgical fasteners 50 b are disposed therebetween.By providing the surgical fasteners 50 a-50 c and pusher plates 2160with complementary heights, the various sized-staples are formed againstthe anvil of the stapler into the desired shape. It is also envisionedthat other arrangements of pusher plates and surgical fasteners may beused.

In various instances, the staple cartridge 2140 may include a singleplanar tissue contacting surface and the anvil member may be providedwith more than one tissue contacting surface so as to define more thanone gap with respect to the tissue contacting surface of the staplecartridge. One or both of the staple cartridge and anvil member may havestepped surfaces, angled or sloped surfaces, or curved surfaces that areselected to correspond to staples having predetermined leg lengths. Incertain embodiments, more than one tissue contacting surface isprovided, on the staple cartridge, the anvil member, or both, withsloped surfaces extending therebetween. In certain embodiments, thestaple pushers have heights corresponding to the different staple sizes.The anvil pockets of the anvil assembly, the staple pushers, and/or theactuation sled are arranged to form each of the different sized staplesin the desired closed shapes.

In certain instances, staple cartridge 2140 includes at least one doublestaple pusher 2170, at least one triple staple pusher 2160 and at leastone quadruple staple pusher 2180. As seen in FIG. 3A, double staplepusher 2170 has only two pusher plates 2176, triple staple pusher 2160has three pusher plates 2166, and quadruple staple pusher 2180 has fourpusher plates 2186. The staples and pushers are arranged in a pattern ona first side 2148 a of knife channel 2148 and on a second side 2148 b ofknife channel 2148, so as to form three longitudinal rows of staples oneach side of knife channel 2148.

In certain instances, the rows of staples 50 a are positioned at regularintervals along a first longitudinal axis. Spaces between adjacent rowsof staples 50 a can be referred to as staple gaps in the firstlongitudinal axis as tissue positioned over such spaces will not bestapled by staples 50 a. The rows of staples 50 b are also positioned atregular intervals along a second longitudinal axis. The staples 50 b arestaggered with respect to the staples 50 a. The staples 50 b arepositioned laterally with respect to the staple gaps in the row ofstaples 50 a. Spaces between adjacent staples 50 b can also be referredto as staple gaps in the second longitudinal axis as tissue positionedover such spaces will not be stapled by the staples 50 b. The staples 50c are also positioned at regular intervals along a third longitudinalaxis. The staples 50 c are staggered with respect to the staples 50 b.The staples 50 c are positioned laterally with respect to the staplegaps in the row of staples 50 b.

Double staple pushers 2170 are disposed at the proximal end of staplecartridge 2140 and are adapted to deploy the most proximal staples 50 band 50 c through retention slots 2144 of rows 2144 b and 2144 c,respectively. One double staple pusher 2170 interacts with two mostproximal staples 50 b and 50 c disposed in retention slots 2144 of rows2144 b and 2144 c. Quadruple staple pushers 2180 are positioned in thedistal end of staple cartridge 2140 and are configured to deploy four ofthe distal most staples 50 a and 50 c, including the staples which aredeployed through the distal most retention slots 2144 of rows 2144 c,2144 a. The quadruple staple pushers 2180 interact with another staple50 a in the outermost retention slots 2144 of rows 2144 a, as well as astaple 50 b in retention slots 2144 of rows 2144 b. For each side 2148a, 2148 b of the staple cartridge, one double staple pusher 2170 isdisposed at a proximal end of the staple cartridge 2140 and onequadruple staple pusher 2180 at the distal end of the staple cartridge2140. The pushers are arranged in a mirror-image of each other, ineither side of the staple cartridge.

A plurality of triple staple pushers 2160 extend between double staplepushers 2170 and quadruple staple pushers 2180 in a longitudinal mannerand are configured to deploy the staples 50 a, 50 b and 50 c fromretention slots 2144 of the innermost rows 2144 c, middle rows 2144 b,and outermost rows 2144 a. One triple staple pusher 2160 interacts withone staple 50 a disposed in retention slot 2144 of the outermost row2144 a, one staple 50 b disposed in retention slot 2144 of rows 2144 b,and one staple 50 c disposed in retention slot 2144 of the innermost row2144 c. The pusher plates of the triple staple pushers 2160 have heightsthat correspond to the size of the staples, as discussed above.

Referring now to FIGS. 2A and 2B, an end effector 500 is depicted. Theend effector 500 can be employed with the surgical instrument 10. Forexample, as illustrated in FIG. 2A, the end effector 500 may be coupledto and extend from the body portion 12. The end effector 500 maycomprise a staple cartridge such as, for example, the stable cartridge40 (FIG. 2 ), the stable cartridge 40′ (FIG. 3 ), and/or the stablecartridge 2140 (FIG. 3A). In addition, the end effector 500 may includean anvil assembly such as, for example, the anvil assembly 70 (FIG. 2 )and/or the anvil assembly 604 (FIG. 3C).

FIG. 2A depicts an end effector 500 comprising the stable cartridge 2140and the anvil assembly 70, for example. In certain instances, the anvilassembly 70 can be movable toward the staple cartridge 2140 (FIG. 3A) tocapture tissue therebetween in response to actuation of the trigger 32,for example. As illustrated in FIG. 2A, the end effector 500 includes acartridge channel 506 which can extend distally from the body portion12. The cartridge channel 506 can be configured to receive a staplecartridge such as the staple cartridge 2140, for example. In certaininstances, the cartridge channel 506 is fixedly attached to the bodyportion 12. A proximal portion 508 of the cartridge channel 506 mayextend, or substantially extend, along a longitudinal axis AA defined bythe body portion 12, as illustrated in FIG. 2A. In certain instances, adistal portion 510 of the cartridge channel 506 may deviate from thelongitudinal axis AA. The distal portion 510 may extend in a directionthat intersects the longitudinal axis AA at an angle a, as illustratedin FIG. 2A, for example.

In certain instances, the angle a can be any angle selected from a rangeof about 5 degrees, for example, to about 90 degrees, for example. Incertain instances, the angle a can be any angle selected from a range ofabout 20 degrees, for example, to about 80 degrees, for example. Incertain instances, the angle a can be any angle selected from a range ofabout 30 degrees, for example, to about 50 degrees, for example. In atleast one instance, the angle a can be about 45 degrees, for example.

Referring again to FIGS. 2A and 2B, the distal portion 510 of thecartridge channel 506 may include a hooking region 514 which can becomprise of a depression in the distal portion 510, for example. Asillustrated in FIG. 2B, the hooking region 514 can be configured tocapture anatomical structures such as, for example, a blood vessel. Incertain instances, the distal portion 510 may comprise a pointed tip 512which can facilitate positioning of a staple carriage such as the staplecartridge 2140 underneath tissue to be captured between the staplecartridge 2140 and the anvil assembly 70. The pointed tip 512 can beemployed to atraumatically dissect connective tissue, for example, inorder to provide a path for positioning the staple cartridge 2140 withrespect to an anatomical structure. The anvil assembly 70 can then bemoved to capture the anatomical structure between the staple cartridge2140 and the anvil assembly 70. In certain instances, the depression isproximal to the pointed tip 512.

In certain instances, as illustrated in FIGS. 2A and 2B, the distalportion 510 may comprise a ramp portion 515. The ramp portion 515 may beconfigured to facilitate a transition of tissue caught in the depressionof the distal portion 510 to a staple cartridge such as, for example,the staple cartridge 2140. As described herein, the staple cartridge2140 may comprise stepped tissue contacting and/or supporting surfaces2161 a, 2161 b, and 2161 c. In such instances, the ramp portion 515 canbe configured to facilitate the transition of tissue from the depressionof the distal portion 510 to the stepped tissue contacting surfaces 2161a, 2161 b, and 2161 c. In at least one example, the ramp portion 515 maybe split into three sub-ramps that each lead to one of the tissuecontacting surfaces 2161 a, 2161 b, and 2161 c, for example.

FIG. 3C illustrates a “V” shaped fastener 520. In certain instances, oneor more of the fasteners 50 a, 50 b, and/or 50 c may comprise “V” shapeswhich can be similar to the “V” shape” of the fastener 520 depicted inFIG. 3C. In certain instances, the staple cartridge 2140 may comprise aplurality of “V” shaped fasteners 50 a, 50 b, and 50 c. The “V” shapedfasteners 50 a, 50 b, and 50 c can be housed, or at least partiallyhoused, within the retention slots 2144 of the staple cartridge 2140 fordeployment into tissue captured between the staple cartridge 2140 and ananvil assembly such as, for example, the anvil assembly 70 (FIG. 2 )and/or the anvil assembly 604 (FIG. 3C).

Referring to FIG. 3C, a “V” shaped staple 520 may be comprised of a base522, a first leg 524, and a second leg 526. In certain instances, asillustrated in FIG. 3C, the legs 524 and 526 may extend from the base522 in a plane intersecting the base 522. In certain instances, thefirst leg 524 and/or the second 526 can form an angle 13 with the base522. In certain instances, the angle 13 can be greater than 90 degrees,for example.

FIG. 3D illustrates a “U” shaped fastener 528. In certain instances, oneor more of the fasteners 50 a, 50 b, and/or 50 c may comprise “U” shapeswhich can be similar to the “U” shape” of the fastener 528 depicted inFIG. 3D. In certain instances, the staple cartridge 2140 may comprise aplurality of “U” shaped fasteners 50 a, 50 b, and 50 c. The “U” shapedfasteners 50 a, 50 b, and 50 c can be housed, or at least partiallyhoused, within the retention slots 2144 of the staple cartridge 2140 fordeployment into tissue captured between the staple cartridge 2140 and ananvil assembly such as, for example, the anvil assembly 70 (FIG. 2 )and/or the anvil assembly 604 (FIG. 3C).

Referring to FIG. 3D, a “U” shaped staple 528 may be comprised of a base530, a first leg 532, and a second leg 534. In certain instances, asillustrated in FIG. 3D, the legs 532 and 534 may extend from the base530 in a plane intersecting the base 530. In certain instances, thefirst leg 532 and/or the second 534 can form an angle 8 with the base530. In certain instances, the angle 8 can be about 90 degrees, forexample, as illustrated in FIG. 3D.

In various instances, one or more of the staple cartridges of thepresent disclosure such as, for example, the staple cartridge 40, thestaple cartridge 40′, and/or the staple cartridge 2140 can be equippedwith retaining features configured to releasably secure “U” shapedstaples such as, for example, the “U” shaped staples 50 a-50 c withintheir respective retention slots while a staple cartridge is beingmaneuvered for positioning relative to tissue. In at least one example,one or more of the staple pushers incorporated into the above-mentionedstaple cartridges such as, for example, the staple pushers 160 (FIG. 1), the staple pushers 260 (FIG. 1A), the staple pushers 360 (FIG. 1B),the staple pushers 460 (FIG. 1C), the staple pushers 760 (FIG. 1D), thestaple pushers 860 (FIG. 1E), and/or the staple pushers 2160 (FIG. 2B)can be modified to include retaining features, as described in greaterdetail hereinafter, for releasably securing “U” shaped staples withintheir respective retention slots.

FIG. 3E depicts a staple pusher 540 which includes a retaining feature542 that can be employed to releasably secure a “U” shaped staple 528within a retention slot of a staple cartridge such as, for example, thestaple cartridge 40, the staple cartridge 40′, and/or the staplecartridge 2140. As illustrated in FIG. 3E, in certain instances, a “U”shaped staple 528 can be releasably secured to the staple pusher 540 bypositioning a base 530 of the “U” shaped staple between a retaining hook544 of the retaining feature 542 and a pusher plate comprising a firstpusher plate portion 546 and a second pusher plate portion 548, forexample. In at least one example, the first pusher plate portion 546 andthe second pusher plate portion 548 may reside on opposite ends of thestaple pusher 540, as illustrated in FIG. 3E.

In certain instances, the first pusher plate portion 546 may comprise achannel configured to receive a first base portion 550 of the base 530.The leg 532 may extend from the first base portion 550. Furthermore, thesecond pusher plate portion 548 may comprise a channel configured toreceive a second base portion 552 of the base 530. The leg 534 mayextend from the second base portion 552. In certain instances, theretaining hook 544 may receive, or at least partially receive, anintermediate base portion 554 extending between the first base portion550 and the second base portion 552, as illustrated in FIG. 3E.

In certain instances, a “U” shaped staple 528 can be loaded onto astaple pusher 540 by positioning the base 530 of the “U” shaped staple528 between the retaining hook 544 and the first pusher plate portion546 and the second pusher plate portion 548. To load the “U” shapedstaple 528 onto a staple pusher 540, the base 530 can be pressed againsta top end 558 of the retaining hook 544 which may cause a springingmember 556 to be moved giving way to the base 530 to drop into a finalposition. In the final position, the first base portion 550 is receivedby the channel of the first pusher plate portion 546 and the second baseportion 552 is received by the channel of the second pusher plateportion 548, as illustrated in FIG. 3E. In certain instances, thespringing member 556 is permitted to spring the retaining hook 544 intolocking engagement with the base 530 once the base 530 passes the topend 558 into the final position, as illustrated in FIG. 3E.

The reader will appreciate that the retaining hook 544 can maintain thebase 530 in the final position while a staple cartridge carrying the “U”shaped staple 528 is maneuvered to a suitable position relative totissue. Upon reaching the suitable position, the “U” shaped staple 528can be ejected from the staple cartridge and formed by an anvil assemblysuch as, for example the anvil assembly 70 to bond the “U” shaped staple528 to the tissue. The bond between the formed, or at least forming, “U”shaped staple 528 and the tissue can cause the “U” shaped staple 528 tobe pulled free from the retaining hook 544 as the staple cartridge isremoved from the stapled tissue, or vice versa. In other words, removingthe staple cartridge from the stapled tissue, or vice versa, may causethe base 530 to press against the springing member 556 and move out oflocking engagement with the retaining hook 544. Other releasingmechanisms for releasing the “U” shaped staple 528 from lockingengagement with the retaining hook 544 are contemplated by the presentdisclosure.

In various instances, referring primarily to FIGS. 3F-3H, a “U” shapedstaple 528 can be releasably secured to a staple pusher 560. Like thestaple pusher 540, the staple pusher 560 can releasably secure a “U”shaped staple 528 within a retention slot of a staple cartridge such as,for example, the staple cartridge 40, the staple cartridge 40′, and/orthe staple cartridge 2140. In certain instances, the staple pusher 560may include a pusher plate 562. As illustrated in FIG. 3G, the pusherplate 562 may comprise a channel 563. The channel 563 may define anopening 564 comprising a width d2, as illustrated in FIG. 3G.

In certain instances, the width d2 can be slightly smaller than a widthd1 of the base 530 of the “U” shaped staple 528. To load the “U” shapedstaple 528 onto the staple pusher 560, the base 530 may be pressedagainst the pusher plate 562. In certain instances, the base 530 may beforced through the slightly smaller opening 564. As illustrated in FIG.3H, the resulting tight fit between the channel and the base 530 mayallow the channel 563 to releasably retain at least a portion of thebase 530. In certain instances, walls of the channel 563 can be deformedto accommodate the base 530. In at least one example, one or more of thewalls of the channel 563 can be comprised of a deformable material whichmay deform under pressure from the base 530 to create a tight fitbetween the channel 563 and the base 530. In certain instances, one ormore of the walls of the channel 563 can be comprised of one or moredeformable soft metals, for example. In certain instances, one or moreof the walls of the channel 563 can be comprised of one or moredeformable plastics, for example.

In certain instances, the width d1 can be any width selected from arange of about 0.0050 inch, for example, to about 0.0100 inch, forexample. In certain instances, the width d1 can be any width selectedfrom a range of about 0.0060 inch, for example, to about 0.0090 inch,for example. In certain instances, the width d1 can be any widthselected from a range of about 0.0070 inch, for example, to about 0.0080inch, for example. In certain instances, the width d1 can be about0.0079 inch, for example.

In certain instances, the width d2 can be any width selected from arange of about 0.0050 inch, for example, to about 0.0100 inch, forexample. In certain instances, the width d2 can be any width selectedfrom a range of about 0.0055 inch, for example, to about 0.0085 inch,for example. In certain instances, the width d2 can be any widthselected from a range of about 0.0060 inch, for example, to about 0.0075inch, for example. In certain instances, the width d2 can be about0.0069 inch, for example.

In certain instances, the ratio of the width d2 to the width d1 can beany value selected from a range of about 0.70, for example, to about0.95, for example. In certain instances, the ratio of the width d2 tothe width d1 can be any value selected from a range of about 0.75, forexample, to about 0.90, for example. In at least one example, the ratioof the width d2 to the width d1 is 0.87. In at least one example, thewidth d1 is 0.0079 inch and the width d2 is 0.0069.

In various instances, a staple cartridge of the present disclosure suchas, for example, the staple cartridge 40, the staple cartridge 40′,and/or the staple cartridge 2140 may comprise retention slots equippedwith retention mechanisms configured to releasably secure staples suchas, for example, the “U” shaped staple 528 while the staple cartridge isbeing maneuvered for positioning relative to tissue. For example, FIGS.3I and 3J depict a retention slot 570 comprising a retention mechanism571 which can be employed to releasably secure a “U” shaped staple 528.

In certain instances, referring to FIG. 3I, the retention mechanism 571can be configured to resist release of a “U” shaped staple 528 throughan opening 572 of the retention slot 570. In certain instances, theopening 572 may comprise a first narrow end portion 574 and a secondnarrow end portion 576. As illustrated in FIG. 3I, the first narrow endportion 574 and the second narrow end portion 578 can be located onopposite ends of the retention slot 570.

In at least one example, as illustrated in FIG. 3J, the first narrow endportion 574 comprises a first bendable seal 576 extending, or at leastpartially extending, across the opening 572 to create the first narrowend portion 574. Likewise, the second narrow end portion 578 maycomprise a second bendable seal 580 extending, or at least partiallyextending, across the opening 572 to create the second narrow endportion 576.

In certain instances, as illustrated in FIG. 3J, the first bendable seal576 may resist passage of the leg 532 therethrough. In certaininstances, the second bendable seal 580 may resist passage of the leg534 therethrough. To eject the “U” shaped staple 528, a staple pushersuch as, for example, the staple pusher 160 (FIG. 1 ), the staple pusher260 (FIG. 1A), the staple pusher 360 (FIG. 1B), the staple pusher 460(FIG. 1C), the staple pusher 760 (FIG. 1D), the staple pusher 860 (FIG.1E), and/or the staple pusher 2160 (FIG. 2B) may motivate the “U” shapedstaple 528 to exit the retention slot 570. In such instances, the leg532 and the leg 534 may be motivated to press against the first bendableseal 576 and the second bendable seal 580, respectively, to cause thefirst bendable seal 576 and the second bendable seal 580 to bend to giveway for passage of the leg 532 and the leg 534, respectively.

In certain instances, the first bendable seal 576 and/or the secondbendable seal 580 may comprise a plurality of bendable tabs 582. Thetabs 582 may resist release of a staple such as, for example, the “U”shaped staple 528 from the retention slot 570. As illustrated in FIG.3J, a tab 582 may extend across, or at least partially across, theopening 572, for example. As described above, to eject the “U” shapedstaple 528, a staple pusher may motivate the “U” shaped staple 528 toexit the retention slot 570. In certain instances, the leg 532 and/orthe leg 534 may be motivated to force open a passage between the tabs582 by causing one or more of the tabs 582 to bend thereby permittingthe release of the “U” shaped staple 528.

Referring now to FIGS. 2C and 2D, an end effector 600 is depicted. Theend effector 600 is similar in many respects to the end effector 500(FIG. 2A). Like the end effector 500, the end effector 600 can beemployed with the surgical instrument 10 (FIG. 2 ). Also, like the endeffector 500, the end effector 600 may comprise an anvil assembly 604and a cartridge channel 601 which can be configured to receive a staplecartridge such as, for example, the stable cartridge 40 (FIG. 2 ), thestable cartridge 40′ (FIG. 3 ), and/or the stable cartridge 2140 (FIG.3A). Furthermore, like the cartridge channel 506 of the end effector500, the cartridge channel 601 of the end effector 600 may be fixedlyattached to the body portion 12 (FIG. 2 ) of the surgical instrument 10and may comprise the distal portion 510 which may deviate from alongitudinal axis defined by the cartridge channel 601.

In certain instances, as illustrated in FIG. 2D, the end effector 600comprises a staple cartridge 602 and an anvil assembly 604. The anvilassembly 604 is similar in many respects to the anvil assembly 70 (FIG.2 ). For example, like the anvil assembly 70, the anvil assembly 604 canbe movable toward a staple cartridge such as, for example, the staplecartridge 602 to capture tissue therebetween in response to actuation ofthe trigger 32, for example.

Referring again to FIG. 2D, the staple cartridge 602 is similar in manyrespects to the staple cartridge 2140. For example, like the staplecartridge 2140, the staple cartridge 602 comprises the tissue contactingportion 2161, the staple pusher plates 2166 a-2166 c, the retentionslots 2144 a-2144 c, and the staples 50 a-50 c. As described above, thetissue contacting portion 2161 includes tissue contacting surfaces 2161a, 2161 b, and 2161 c which are stepped. Also as described above, thetissue contacting surfaces 2161 a, 2161 b, and 2161 c include differentheights as measured from the datum at the top of the knife channel 2148.In certain instances, as illustrated in FIG. 2D, the tissue contactingsurface 2161 c has a greater height than the tissue contacting surface2161 b, for example, and the tissue contacting surface 2161 b has agreater height than the tissue contacting surface 2161 a, for example.

Further to the above, the anvil assembly 604 may include a tissuecontacting portion 608. The tissue contacting portion 608 includestissue contacting surfaces 608 a, 608 b, and 608 c. Like the tissuecontacting surfaces 2161 a-2161 c, the tissue contacting surfaces 608a-608 c are planar, or at least substantially planar, structures thatare substantially parallel to one another, but are not co-planar withone another. Also like the tissue contacting surfaces 2161 a-2161 c, thetissue contacting surfaces 608 a-608 c are stepped. In certaininstances, as illustrated in FIG. 3D, the stepped arrangement of thetissue contacting surfaces 2161 a, 2161 b, and 2161 c can be a mirrorimage to the stepped arrangement of the tissue contacting surfaces 608a, 608 b, and 608 c, respectively.

In certain instances, a set of tissue contacting surfaces 608 a-608 c isdisposed on each side of the knife channel 2148. The tissue contactingsurfaces 608 a-608 c include different heights as measured from thedatum at the top of the knife channel 2148, for example. Additionally,the tissue contacting surfaces 608 a on opposite sides of the knifechannel 2148 can be co-planar with one another. Similarly, the tissuecontacting surfaces 608 b on opposite sides of the knife channel 2148can be co-planar with one another. Furthermore, the tissue contactingsurfaces 608 c on opposite sides of the knife channel 2148 can beco-planar with one another. Although the drawings show planar tissuecontacting and/or supporting surfaces 608 a-608 c, the presentdisclosure envisions curved or angled tissue contacting surfaces as wellas other kinds of tissue contacting surfaces having other shapes andstructures.

A wall or any other suitable structure interconnects the tissuecontacting surfaces 608 a and 608 b. Similarly, a suitable structuresuch as a wall interconnects the tissue contacting surfaces 608 b and608 c. The walls or interconnecting structures may be orientedorthogonally with respect to the tissue contacting surfaces 608 a-608 c.The present disclosure, however, contemplates walls or interconnectingstructures oriented in different directions such as angled, curved orother configurations.

In the embodiment illustrated in FIG. 2D, the end effector 600 isdepicted in a fully approximated configuration. As illustrated in FIG.2D, the tissue contacting surfaces 608 a-608 c of the anvil assembly 602are stepped such that the most interior tissue contacting surface 608 cis closest to the staple cartridge 602 while the most exterior tissuecontacting surface 608 a is furthest from the staple cartridge 602.Likewise the tissue contacting surfaces 2161 a-2161 c of the staplecartridge 602 are stepped such that the most interior tissue contactingsurface 2161 c is closest to the anvil assembly 604 while the mostexterior tissue contacting surface 2161 c is furthest from the staplecartridge.

The reader will appreciate that as tissue is compressed between theanvil assembly 604 and the staple cartridge 602, a tissue compressiongradient can be created. The tissue captured between the tissuecontacting surfaces 2161 c and 608 c may experience a greatercompression than the tissue captured between the tissue contactingsurfaces 2161 b and 608 b. Also, the tissue captured between the tissuecontacting surfaces 2161 b and 608 b may experience a greatercompression than the tissue captured between the tissue contactingsurfaces 2161 a and 608 a. The resulting tissue compression gradient maycause fluid within the tissue captured between the anvil assembly 604and the staple cartridge 602 to diffuse or flow outward in a directionaway from the knife channel 2148.

Referring now to FIG. 1A, a staple drive assembly 200 is depicted. Thestaple drive assembly 200 is similar in many respects to the stapledrive assembly 100 (FIG. 1 ). Like the staple drive assembly 100, thestaple drive assembly 200 is adapted for use with a surgical staplersuch as, for example, the surgical stapler 10 (FIG. 2 ). Also, like thestaple drive assembly 100, the staple drive assembly 200 can beincorporated into the stable cartridge 40 (FIG. 2 ), the stablecartridge 40′ (FIG. 3 ), the staple cartridge 602 (FIG. 2C), and/or thestable cartridge 2140 (FIG. 3A), for example.

As illustrated in FIG. 1A, the staple drive assembly 200 includes anactuation sled 210 and at least one staple pusher arrangement or system260. The actuation sled 210 includes a base 212, a first camming member220, a second camming member 240, and a guide member 250. The firstcamming member 220 and the second camming member 240 can be located onopposite sides of the guide member 250. The first and second cammingmembers 220, 240 include respective first or leading cam wedges 222, 242and respective second or trailing cam wedges 224, 244, for example.

The actuation sled 210 is translatable to motivate at least one staplepusher arrangement or system 260 to eject staples such as, for example,the staples 50 a-50 c, the staples 520, and/or the staples 528 from astaple cartridge into tissue captured by the surgical instrument 10. Thestaple pusher 260 is similar in many respects to the staple pusher 160.For example, like the staple pusher 160, the staple pusher 260 includesstaggered pusher plates 266 a-266 c which are similar in many respectsto the staggered pusher plates 166. Also, like the staple pusher 160,the staple pusher 260 comprises a camming member 164 which is configuredto couple the middle pusher plate 266 b and the outboard pusher plate266 c, as illustrated in FIG. 1A.

However, unlike the staple pusher 160, the staple pusher 260 lacks thecamming member 162. Accordingly, the inboard pusher plate 266 a of thepusher plate 260 can be moved independently relative to the middle andoutboard pusher plates 266 which are coupled by the camming member 164.In certain instances, the inboard pusher plate 266 a may comprise aseparate camming member 262, as illustrated in FIG. 1A, which can beengaged with a leading cam wedge such as, for example, the cam wedge 222as the actuation sled 210 is translated to motivate the at least onestaple pusher arrangement or system 260 to eject staples.

In certain instances, as illustrated in FIG. 1A, the leading cam wedges222, 242 may comprise steeper drive angles in comparison to the trailingcam wedges 224, 244, for example. In such instances, as the actuationsled 210 is advanced against the staple pusher 260, the camming member262 may be elevated faster than the camming member 164. Accordingly, theinboard pusher plate 266 a, which is coupled to the camming member 262,can be elevated faster than the outboard pusher plate 266 c and middlepusher plate 266 b, which are coupled to the camming member 164. Astaple driven by the faster elevated inboard pusher plate 266 a may befully-formed faster than simultaneously ejected staples which are drivenby the slower elevated outboard pusher plate 266 c and middle pusherplate 266 b, for example.

In certain instances, as illustrated in FIG. 1A, the leading cam wedges222, 242 may terminate higher than the trailing cam wedges 224, 244, forexample. Said another way, proximal ends of the leading cam wedges 222,242 may comprise greater vertical heights than proximal ends of thetrailing cam wedges 224, 244, for example. In such instances, as theactuation sled 210 is advanced against the staple pusher 260, thecamming member 262 may be elevated higher than the camming member 164.Accordingly, the inboard pusher plate 266 a, which is coupled to thecamming member 262, can be elevated higher than the outboard pusherplate 266 c and middle pusher plate 266 b, which are coupled to thecamming member 164. A staple driven by the higher elevated inboardpusher plate 266 a may be compressed to a greater degree in afully-formed configuration than similarly sized and simultaneouslyejected staples that are driven by the lower elevated outboard pusherplate 266 c and middle pusher plate 266 b, for example.

In certain instances, the ratio of the drive angles of the trailing camwedges 224, 244 to the drive angles of the leading cam wedges 222, 242,respectively, can be selected from a range of about 0.7, for example, toabout 0.9, for example. In at least one example the ratio can be about0.8, for example.

In certain instances, the ratio of the vertical heights of the proximalends of the trailing cam wedges 224, 244 to the vertical heights of theproximal ends of the leading cam wedges 222, 242, respectively, can beselected from a range of about 0.7, for example, to about 0.9, forexample. In at least one example the ratio can be about 0.8, forexample.

In certain instances, as illustrated in FIG. 1A, the leading cam wedges222, 242 may terminate prior to the trailing cam wedges 224, 244, forexample. Said another way, the trailing cam wedges 224, 244 may extendproximally beyond the leading cam wedges 222, 242. In such instances, asthe actuation sled 210 is advanced against a staple pusher 260, thecamming member 164 of the staple pusher 260 may be driven by a trailingcam wedge for a longer period of time than the camming member 262 of thestaple pusher 260 is driven by a leading cam wedge, for example.Accordingly, staples deployed by the longer driven middle pusher plate266 b and outboard pusher plate 266 c can be fully-formed after asimultaneously ejected staple which is deployed by the shorter driveninboard pusher plate 266 c is fully-formed, for example.

The reader will appreciate that the independent movement of the inboardpusher plate 266 a from the middle pusher plate 266 b and outboardpusher plate 266 c in response to the advancement of the actuation sled210 against the staple pusher 260 allows a staple driven by the inboardpusher plate 266 a to be fully-formed faster and/or to a greater finalcompression than simultaneously ejected staples that are driven by themiddle pusher plate 266 b and outboard pusher plate 266 c.

The reader will also appreciate that the time lag between the formationof a staple ejected by the inboard pusher plate 266 a and staplesejected by the middle pusher plate 266 b and the outboard pusher plate266 c may provide a greater opportunity for outward fluid diffusionthrough tissue receiving such staples. Furthermore, incorporation of thestaple drive assembly 200 into a cartridge assembly 602 of the endeffector 600 (FIG. 2C) may further increase the opportunity availablefor outward fluid diffusion by combining the faster ejection and/orcomplete formation of staples ejected by the inboard pusher plate 266 awith the compression gradient generated by the anvil assembly 604 andthe staple cartridge 602, for example.

Referring now to FIG. 1B, a staple drive assembly 300 is depicted. Thestaple drive assembly 300 is similar in many respects to the stapledrive assembly 100 (FIG. 1 ). Like the staple drive assembly 100, thestaple drive assembly 300 is adapted for use with a surgical staplersuch as, for example, the surgical stapler 10. Also, like the stapledrive assembly 100, the staple drive assembly 300 can be incorporatedinto the stable cartridge 40 (FIG. 2 ), the stable cartridge 40′ (FIG. 3), the staple cartridge 602 (FIG. 3A) and/or the stable cartridge 2140(FIG. 3A), for example. However, unlike the staple drive assembly 100,the staple drive assembly 300 is configured to simultaneously deploythree inversely staggered staples 50 a-50 c. The three inverselystaggered staples 50 a-50 c are arranged such that the inner most staple50 c is in a proximal, or at least partially proximal, position to themiddle staple 50 b with respect to the distal portion of the staplecartridge and the middle staple 50 b is in a proximal, or at leastpartially proximal, position to the outer most staple 50 a with respectto the distal portion of the staple cartridge. Furthermore, the innermost staple 50 c comprises a smaller fully-formed height than the middlestaple 50 b and the middle staple 50 b comprises a smaller fully-formedheight than the outer most staple 50 a, for example.

As illustrated in FIG. 1B, the staple drive assembly 300 includes anactuation sled 310 and at least one staple pusher arrangement or system360. The at least one staple pusher arrangement or system 360 includesinversely staggered pusher plates 366 a-366 c. The actuation sled 310includes a base 312, a first camming member 320, a second camming member340, and a guide member 350. The first camming member 320 and the secondcamming member 340 can be located on opposite sides of the guide member350. The first and second camming members 320, 340 include respectivefirst or leading cam wedges 322, 342 and respective second or trailingcam wedges 324, 344, for example.

Unlike the actuation sled 110 of the staple drive assembly 100, theactuation sled 310 of the staple drive assembly 300 comprises outwardleading cam wedges and inward trailing cam wedges corresponding to theinversely staggered pusher plates 366 a-366 c. For example, asillustrated in FIG. 1B, the leading cam wedge 322 is laterally spacedfurther away from the guide member 350 than the trailing cam wedge 324and the leading cam wedge 342 is laterally spaced further away from theguide member 350 than the trailing cam wedge 344.

Further to the above, as illustrated in FIG. 1B, the pusher plates 366a-366 c of the staple pusher 360 of the staple drive assembly 300 areinversely staggered such that an outboard pusher plate 366 c, which isfurthest from the knife channel 2148, is closer to a distal portion of astaple cartridge that incorporates the staple pusher 360 than a middlepusher plate 366 b and the middle pusher plate 366 b is closer to thedistal portion of the staple cartridge than the inboard pusher plate 366a, which is closest to the knife channel 2148, for example. Said anotherway, the inboard pusher plate 366 a lags behind the middle pusher plate366 b and the middle pusher plate 366 b lags behind the outboard pusherplate 366 c, for example.

Further to the above, as illustrated in FIG. 1B, the inboard pusherplate 366 a comprises a greater vertical height than the middle pusherplate 366 b and the middle pusher plate 366 b comprises a greatervertical height the outboard pusher plate 366 c. The inboard pusherplate 366 a deploys a first staple 50 c comprising a first unformedheight. The middle pusher plate 366 b deploys a second staple 50 bcomprising a second unformed height greater than the first unformedheight of the first staple 50 c. The outboard pusher plate 366 c deploysa third staple 50 a comprising a third unformed height greater than thesecond unformed height of the second staple 50 b, for example.Furthermore, the first staple 50 c comprises a smaller fully-formedheight than the second staple 50 b and the second staple 50 b comprisesa smaller fully-formed height than the third staple 50 a, for example.Like the inversely staggered pusher plates 366 a-366 c, the staples 50a, 50 b, and 50 c, which are simultaneously deployed by the pusherplates 366 c, 366 b, and 366 a respectively, comprise an inverselystaggered arrangement such that the third staple 50 a is closer to adistal portion of a staple cartridge that incorporates the staple pusher360 than the second staple 50 b and the second staple 50 b is closer toa distal portion of the staple cartridge than the first staple 50 c.

Referring now to FIGS. 1C and 1D, staple drive assemblies 400 and 700are depicted. The staple drive assemblies 400 (FIG. 1C) and 700 (FIG.1D) are similar in many respects to the staple drive assembly 100 (FIG.1 ). Like the staple drive assembly 100, the staple drive assemblies 400and 700 are adapted for use with a surgical stapler such as, forexample, the surgical stapler 10. Also, like the staple drive assembly100, the staple drive assemblies 400 and 700 can be incorporated intothe stable cartridge 40 (FIG. 2 ), the stable cartridge 40′ (FIG. 3 ),the staple cartridge 602 (FIG. 2C), and/or the stable cartridge 2140(FIG. 3A), for example.

As illustrated in FIG. 1C, the staple drive assembly 400 includes anactuation sled 410 and at least one staple pusher arrangement or system460. The actuation sled 410 includes a base 412, a first camming member420, a second camming member 440, and a guide member 450. The firstcamming member 420 and the second camming member 440 can be located onopposite sides of the guide member 450. The first and second cammingmembers 420, 440 include respective first or leading cam wedges 422, 442and respective second or trailing cam wedges 424, 444, for example.

The actuation sled 410 is translatable to motivate at least one staplepusher arrangement or system 460 to eject staples such as, for example,the staples 50 a-50 c, the staples 520, and/or the staples 528 from astaple cartridge into tissue captured by the surgical instrument 10. Thestaple pusher 460 is similar in many respects to the staple pusher 160arrangement or system. For example, like the staple pusher 160, thestaple pusher 460 comprises three pusher plates 466 a-466 c. Also, likethe staple pusher 160, the staple pusher 460 comprises camming membersor portions 162 and 164 which couple the pusher plates 466 a-466 c, asillustrated in FIG. 1C.

The pusher plates 466 a-466 c are similar in many respects to the pusherplates 166. For example, like the pusher plates 166, the pusher plates466 are laterally spaced apart such that an inboard pusher plate 466 ais closest to the knife channel 2148 and an outboard pusher plate 466 cis furthest from the knife channel 2148, as illustrated in FIG. 1C. Amiddle pusher plate 466 b is situated between the inboard pusher plate466 a and the outboard pusher plate 466 c, for example.

Further to the above, as illustrated in FIG. 1C, the pusher plates 466a-466 c of the staple pusher 460 of the staple drive assembly 400 arearranged such that the outboard pusher plate 466 c and the middle pusherplate 466 b are laterally aligned with each other. Said another way, theoutboard pusher plate 466 c and the middle pusher plates 466 b areequidistant from a distal portion of a staple cartridge thatincorporates the staple pusher 460, for example. In addition, theinboard pusher plate 466 a is closer to the distal portion of the staplecartridge than the outboard pusher plate 466 c and the middle pusherplates 466 b, for example. In certain instances, the outboard pusherplate 466 c and the middle pusher plate 466 b equally lag in positionproximally behind the inboard pusher plate 466, for example.

Further to the above, as illustrated in FIG. 1C, the inboard pusherplate 466 a comprises a greater vertical height than the middle pusherplate 466 b and, similarly, the middle pusher plate 466 b comprises agreater height the outboard pusher plate 466 c. The inboard pusher plate466 a deploys a first staple 50 c comprising a first unformed height.The middle pusher plate 466 b deploys a second staple 50 b comprising asecond unformed height greater than the first unformed height of thefirst staple 50 c. The outboard pusher plate 466 c deploys a thirdstaple 50 a comprising a third unformed height greater than the secondunformed height of the second staple 50 b, for example. Furthermore, thefirst staple 50 c comprises a smaller fully-formed height than thesecond staple 50 b and the second staple 50 b comprises a smallerfully-formed height than the third staple 50 a, for example. Like thepusher plates 466 a-466 c, the staples 50 a, 50 b, and 50 c, which aresimultaneously deployed by the pusher plates 466 c, 466 b, and 466 arespectively, are arranged such that the third staple 50 a and thesecond staple 50 b equally lag in position proximally behind the firststaple 50 c, as illustrated in FIG. 1C.

In certain instances, the difference in formed height between thestaples 50 a-50 c may create a compression gradient, as described above,that allows fluid diffusion in an outward direction away from the knifechannel 2148. Furthermore, positioning the inboard pusher plate 466 aslightly ahead in position relative to the middle pusher plate 466 b andoutboard pusher plate 466 c may cause an inner row of staples 50 c to bedeployed slightly ahead of a middle row of staples 50 b and an outer rowof staples 50 a. For example, the inner row of staples 50 c can bedeployed one staple ahead of the middle row of staples 50 b and theouter row of staples 50 a.

The lag in the deployment of the middle row of staples 50 b and theouter row of staples 50 a relative to the inner row of staples 50 c maycause a lag in the application of tissue compression as the firingaction of the staple pusher 460 moves from the inner to the outer staplerows. The lag in the application of tissue compression may provideadditional time for the fluid diffusion through the tissue capturedbetween the inner row of staples 50 c and the middle row of staples 50b.

In certain instances, the lateral alignment of the middle pusher plate466 b and the outboard pusher plate 466 c may cause laterally alignedstaples 50 b and staples 50 a of a middle row of staples 50 b and anouter row of staples 50 a, respectively, to be simultaneously formed. Incertain instances, the simultaneous deployment of the laterally alignedstaples 50 b and staples 50 a can provide a better grip onto tissueportions, intended for the lesser compression, to ensure stability inthe outer row of staples 50 a and the middle row of staples 50 b as thestaple pusher 460 is translated distally.

Further to the above, the lateral alignment of the staples 50 a and 50 bmay cause the staple gaps between the staples 50 a of the row of staples50 a and the staple gaps between the staples 50 b of the row of staples50 b to be laterally aligned. In certain instances, the lateralalignment described herein can be complete lateral alignment. In otherinstances, the lateral alignment described herein can be partial lateralalignment. In any event, the lateral alignment of the staples 50 a and50 b may create, or at least substantially create, channels for fluiddiffusion through the laterally aligned staple gaps of the rows ofstaples 50 a and 50 b. In certain instances, as described above, thestaples 50 c are staggered with respect to the laterally aligned staples50 a and 50 b. In such instances, the staples 50 c can be laterallypositioned with respect to the staple gaps the row of staples 50 a andthe staple gaps of the row of staples 50 b. Such a staggered arrangementof the staples 50 c with respect to the laterally aligned staples 50 aand 50 b may ensure hemostasis along the stapled tissue.

As illustrated in FIG. 1D, the staple drive assembly 700 includes anactuation sled 710 and at least one staple pusher arrangement or system760. The actuation sled 710 includes a base 712, a first camming member720, a second camming member 740, and a guide member 750. The firstcamming member 720 and the second camming member 740 can be located onopposite sides of the guide member 750. The first and second cammingmembers 720, 740 include respective first or leading cam wedges 722, 742and respective second or trailing cam wedges 724, 744, for example.

The actuation sled 710 is translatable to motivate at least one staplepusher arrangement or system 760 to eject staples such as, for example,the staples 50 a-50 c, the staples 520, and/or the staples 528 from astaple cartridge into tissue captured by the surgical instrument 10. Thestaple pusher 760 is similar in many respects to the staple pusher 160.For example, like the staple pusher 160, the staple pusher 760 comprisesthree pusher plates 766 a-766 c. Also, like the staple pusher 160, thestaple pusher 760 comprises the camming members or portions162 and 164which are configured to couple the pusher plates 766 a-766 c, asillustrated in FIG. 1D.

The pusher plates 766 a-766 c are similar in many respects to the pusherplates 166. For example, like the pusher plates 166, the pusher plates766 a-766 c are laterally spaced apart such that an inboard pusher plate766 a is closest to the knife channel 2148 and an outboard pusher plate766 c is furthest from the knife channel 2148, as illustrated in FIG.1D. A middle pusher plate 766 b is situated between the inboard pusherplate 766 a and the outboard pusher plates 766 c, for example.

Further to the above, as illustrated in FIG. 1D, the pusher plates 766a- 766 c of the staple pusher 760 of the staple drive assembly 700 arearranged such that the inboard pusher plate 766 a and the middle pusherplate 766 b are laterally aligned with each other. Said another way, theinboard pusher plate 766 a and the middle pusher plate 766 b areequidistant from a distal portion of a staple cartridge thatincorporates the staple pusher 760, for example. In addition, theoutboard pusher plate 766 c is further away from the distal portion ofthe staple cartridge than the inboard pusher plate 766 a and the middlepusher plate 766 b, for example. In other words, the outboard pusherplate 766 c lags in position proximally behind the inboard pusher plate766 a and the middle pusher plate 766 b, for example. Said another way,the inboard pusher plate 766 a and the middle pusher plate 766 b areequally ahead in position distally relative to the outboard pusher plate766 c.

Further to the above, as illustrated in FIG. 1D, the inboard pusherplate 766 a comprises a greater vertical height than the middle pusherplate 766 b and the middle pusher plate 766 b comprises a greatervertical height than the outboard pusher plate 766 c. The inboard pusherplate 766 a deploys a first staple 50 c comprising a first unformedheight. The middle pusher plate 766 b deploys a second staple 50 bcomprising a second unformed height greater than the first unformedheight of the first staple 50 c. The outboard pusher plate 766 c deploysa third staple 50 a comprising a third unformed height greater than thesecond unformed height of the second staple 50 b, for example.Furthermore, the first staple 50 c comprises a smaller fully-formedheight than the second staple 50 b and the second staple 50 b comprisesa smaller fully-formed height than the third staple 50 a, for example.Like the pusher plates 766 a-766 c, the staples 50 a, 50 b, and 50 c,which are simultaneously deployed by the pusher plates 766 c, 766 b, and766 a respectively, are arranged such that the first staple 50 c and thesecond staple 50 b are equally ahead in position distally relative tothe third staple 50 a, as illustrated in FIG. 1D.

In certain instances, the difference in formed height between thestaples 50 a-50 c may create a compression gradient, as described above,that allows fluid diffusion in an outward direction away from the knifechannel 2148. Furthermore, positioning the outboard pusher plate 766 cslightly behind in position relative to the middle pusher plate 766 band the inboard pusher plate 766 a may cause an outer row of staples 50a to be deployed slightly after a middle row of staples 50 b and aninner row of staples 50 c. For example, the outer row of staples 50 acan be deployed one staple behind the middle row of staples 50 b and theinner row of staples 50 c.

The lag in the deployment of the outer row of staples 50 a relative tothe middle row of staples 50 b and the inner row of staples 50 c maycause a lag in the application of tissue compression as the firingaction of the staple pusher 460 moves from the inner to the outer staplerows. The lag in the application of tissue compression may provideadditional time for the fluid diffusion through the captured tissuebetween the middle row of staples 50 b and the outer row of staples 50a.

In certain instances, the lateral alignment of the middle pusher plate766 b and the inboard pusher plate 766 a may cause laterally alignedstaples 50 b and staples 50 c of a middle row of staples 50 b and aninner row of staples 50 c, respectively, to be simultaneously formed. Incertain instances, the simultaneous deployment of the laterally alignedmiddle staples 50 b and inner staples 50 c can provide a better griponto tissue portions captured by the inner row of staples 50 c and themiddle row of staples 50 a as the staple pusher 460 is translateddistally.

Further to the above, the lateral alignment of the staples 50 c and 50 bmay cause the staple gaps between the staples 50 c of the row of staples50 c and the staple gaps between the staples 50 b of the row of staples50 b to be laterally aligned. In certain instances, the lateralalignment described herein can be complete lateral alignment. In otherinstances, the lateral alignment described herein can be partial lateralalignment. In any event, the lateral alignment of the staples 50 c and50 b may create, or at least substantially create, channels for fluiddiffusion through the laterally aligned staple gaps of the rows ofstaples 50 c and 50 b. In certain instances, as described above, thestaples 50 a are staggered with respect to the laterally aligned staples50 c and 50 b. In such instances, the staples 50 a can be laterallypositioned with respect to the staple gaps the row of staples 50 c andthe staple gaps of the row of staples 50 b. Such a staggered arrangementof the staples 50 a with respect to the laterally aligned staples 50 cand 50 b may ensure hemostasis along the stapled tissue.

Referring now to FIG. 1E, a staple drive assembly 800 is depicted. Thestaple drive assembly 800 is similar in many respects to the stapledrive assembly 100 (FIG. 1 ). Like the staple drive assembly 100, thestaple drive assembly 800 is adapted for use with a surgical staplersuch as, for example, the surgical stapler 10. Also, like the stapledrive assembly 100, the staple drive assembly 800 can be incorporatedinto the stable cartridge 40 (FIG. 2 ), the stable cartridge 40′ (FIG. 3), the staple cartridge 602 (FIG. 2C), and/or the stable cartridge 2140(FIG. 3A), for example.

As illustrated in FIG. 1E, the staple drive assembly 800 includes anactuation sled 810 and at least one staple pusher arrangement or system860. The actuation sled 810 includes a base 812, a first camming member820, a second camming member 840, and a guide member 850. The firstcamming member 820 and the second camming member 840 can be located onopposite sides of the guide member 850. The first camming member 820includes a first or leading cam wedge 822 and a second or trailing camwedge 824. The second camming member 840 includes a first or leading camwedge 842 and a second or trailing cam wedge 844. In certain instances,the first camming member 820 can be laterally out of alignment with thesecond camming member 840. In at least one example, as illustrated inFIG. 1E, the second camming member 840 lags in position proximallybehind the first camming member 820 a distance “d1”.

The actuation sled 810 is translatable to motivate a plurality of staplepushers 860 to eject staples such as, for example, the staples 50 a-50c, the staples 520, and/or the staples 528 from a staple cartridge intotissue captured by the surgical instrument 10. In certain instances, thestaple pushers 860 are arranged on opposite sides of the knife channel2148. For example, a first staple pusher 860 a can be positioned on afirst side 2148 a of the knife channel 2148 and a second staple pusher860 b can be positioned on a second side 2148 b, opposite the first side2148 a, of the knife channel 2148. The first staple pusher 860 a and thesecond staple pusher 860 b can be equidistant from a distal portion of astaple cartridge that incorporates the staple pushers 860.

In certain instances, the lag between the first camming member 820 andthe second camming member 840 causes the first camming member 820 toengage the first staple pusher 860 a before the second camming member840 engages the second staple pusher 860 b. In such instances, thestaples driven by the first camming member 820 are ejected, or at leastpartially ejected, before the staples driven by the second cammingmember 840. The reader will appreciate that the lag between theengagement of the first camming member 820 with the first staple pusher860 a and the engagement of the second camming member 840 with thesecond staple pusher 860 b can depend, at least in part, on the distance“d1”.

In certain instances, the displacement of the first camming member 820out of alignment with the second camming member 840 may reduce the forcerequired to eject the staples 50 a-50 c. As the actuation sled 810 istranslated, the camming member 820 may engage the first staple pusher860 a and eject, or at least partially eject, the staples 50 a-50 c ofthe first staple pusher 860 a before the camming member 840 engages thesecond staple pusher 860 b, for example.

In certain instances, the staples 50 a-50 c of the second staple pusher860 b can be in a first phase of ejection while the staples 50 a-50 c ofthe first staple pusher 860 a are in a second later phase of ejection.In certain instances, driving the staples 50 a-50 c through the firstphase of ejection requires a lesser force than driving the staples 50a-50 c through the second phase of ejection. For example, the firstphase of ejection may comprise elevating the staples 50 a-50 c topenetrate tissue captured between an anvil assembly and a tissuecartridge and the second phase of ejection may comprise forming thestaples 50 a-50 c against the anvil assembly.

In certain instances, the lag between the first camming member 820 andthe second camming member 840 can be configured to cause the firstcamming member 820 to be engaged with the first staple pusher 866 a inthe second phase of ejection while the second camming member 840 isengaged with the second staple pusher 866 b in the first phase ofejection. In at least one example, as the actuation sled 810 istranslated, the first camming member 820 and the second camming member840 may alternate between first phases of ejection and second phases ofejection. Accordingly, the force required to translate the actuationsled 820 can be the sum of the force required at a first phase ofejection and at second phase of ejection. The reader will appreciatethat if the first camming member 820 and the second camming member 840are aligned, the force required to translate the actuation sled 810 willbe alternated between the total force required at two first phases ofejection and the total force required at two second phases of ejection.

Further to the above, the staple pusher 860 is similar in many respectsto the staple pusher 160. For example, like the staple pusher 160, thestaple pusher 860 includes staggered pusher plates 866 a-866 c which aresimilar in many respects to the staggered pusher plates 166. Also, likethe staple pusher 160, the staple pusher 860 comprises the cammingmembers 162 and 164 which are configured to couple the pusher plates 866a-866 c, as illustrated in FIG. 1E.

The pusher plates 866 a-866 c are similar in many respects to the pusherplates 166. For example, like the pusher plates 166, the pusher plates866 a-866 c are laterally spaced apart such that an inboard pusher plate866 a is closest to the knife channel 2148 and an outboard pusher plate866 c is furthest from the knife channel 2148, as illustrated in FIG.1E. The middle pusher plate 866 b is situated between the inboard pusherplate 866 a and outboard pusher plates 866 c, for example.

Further to the above, as illustrated in FIG. 1E, the inboard pusherplate 866 a comprises a greater vertical height than the middle pusherplate 866 b and the middle pusher plate 866 b comprises a greatervertical height the outboard pusher plate 866 c. The inboard pusherplate 866 a deploys a first staple 50 c comprising a first unformedheight. The middle pusher plate 866 b deploys a second staple 50 bcomprising a second unformed height greater than the first unformedheight of the first staple 50 c. The outboard pusher plate 866 c deploysa third staple 50 a comprising a third unformed height greater than thesecond unformed height of the second staple 50 b, for example.Furthermore, the first staple 50 c comprises a smaller fully-formedheight than the second staple 50 b and the second staple 50 b comprisesa smaller fully- formed height than the third staple 50 a, for example.

The entire disclosures of:

U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE,which issued on Apr. 4, 1995;

U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on Feb. 21,2006;

U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which issued onSep. 9, 2008;

U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which issued on Dec.16, 2008;

U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;

U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS, whichissued on Jul. 13, 2010;

U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE, which issued on Mar. 12, 2013;

U.S. patent application Ser. No. 11/343,803, entitled SURGICALINSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No. 7,845,537;

U.S. patent application Ser. No. 12/031,573, entitled SURGICAL CUTTINGAND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed Feb. 14, 2008;

U.S. patent application Ser. No. 12/031,873, entitled END EFFECTORS FORA SURGICAL CUTTING AND STAPLING INSTRUMENT, filed Feb. 15, 2008, nowU.S. Pat. No. 7,980,443;

U.S. patent application Ser. No. 12/235,782, entitled MOTOR-DRIVENSURGICAL CUTTING INSTRUMENT, now U.S. Pat. No. 8,210,411;

U.S. patent application Ser. No. 12/249,117, entitled POWERED SURGICALCUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM,now U.S. Pat. No. 8,608,045;

U.S. patent application Ser. No. 12/647,100, entitled MOTOR-DRIVENSURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROLASSEMBLY, filed Dec. 24, 2009, now U.S. Pat. No. 8,220,688;

U.S. patent application Ser. No. 12/893,461, entitled STAPLE CARTRIDGE,filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;

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U.S. patent application Ser. No. 13/800,067, entitled STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. PatentApplication Publication No. 2014/0263552;

U.S. Patent Application Publication No. 2007/0175955, entitled SURGICALCUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM,filed Jan. 31, 2006; and

U.S. Patent Application Publication No. 2010/0264194, entitled SURGICALSTAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed Apr. 22,2010, now U.S. Pat. No. 8,308,040, are hereby incorporated by referenceherein.

Although the various embodiments of the devices have been describedherein in connection with certain disclosed embodiments, manymodifications and variations to those embodiments may be implemented.Also, where materials are disclosed for certain components, othermaterials may be used. Furthermore, according to various embodiments, asingle component may be replaced by multiple components, and multiplecomponents may be replaced by a single component, to perform a givenfunction or functions. The foregoing description and following claimsare intended to cover all such modification and variations.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

1-20. (canceled)
 21. An end effector for a surgical stapling instrument,wherein the end effector is configured to transition between an openconfiguration and a closed configuration, wherein the end effectorcomprises: a staple cartridge, comprising: a cartridge body including aproximal end portion and a distal end portion; an elongate slotextending between the proximal end portion and the distal end portion; adeck surface, comprising: a first tissue-compression surface; a secondtissue-compression surface stepped up from the first tissue-compressionsurface; and a plurality of first staple cavities arranged in a firstrow on a lateral side of the elongate slot, wherein the first rowextends along the first tissue-compression surface; and a plurality ofsecond staple cavities arranged in a second row on the lateral side ofthe elongate slot, wherein the second row is closer to the elongate slotthan the first row, and wherein the second row extends along the secondtissue- compression surface; a set of staples, comprising: a firststaple removably stored in the first row of staple cavities, wherein thefirst staple comprises a first unformed height; and a second stapleremovably stored in the second row of staple cavities, wherein thesecond staple comprises a second unformed height smaller than the firstunformed height, and wherein the second staple is closer to the distalend portion than the first staple; an anvil comprising a thirdtissue-compression surface, wherein a first tissue gap is definedbetween the first tissue-compression surface and the third tissue-compression surface when the end effector is in the closedconfiguration, wherein a second tissue gap is defined between the secondtissue-compression surface and the third tissue-compression surface whenthe end effector is in the closed configuration, and wherein the secondtissue gap is smaller than the first tissue gap; and a staple pushersystem movable to simultaneously deploy the set of staples, wherein thestaple pusher system comprises: a first pusher member configured to liftthe first staple into forming engagement with the anvil such that thefirst staple is formed to a first fully-formed height; and a secondpusher member configured to lift the second staple into formingengagement with the anvil such that the second staple is formed to asecond fully- formed height that is smaller than the first fully-formedheight, and wherein the second pusher member is closer to the distal endportion than the first pusher member.
 22. The end effector of claim 21,wherein the staple cartridge is replaceable with another staplecartridge.
 23. The end effector of claim 21, wherein the anvil furthercomprises a plurality of staple forming pockets defined in the thirdtissue-compression surface.
 24. The end effector of claim 21, whereinthe third tissue-compression surface of the anvil comprises a firstportion and a second portion stepped down from the first portion towardthe staple cartridge.
 25. The end effector of claim 24, wherein thesecond portion of the third tissue-compression surface is closer to theelongate slot than the first portion.
 26. An end effector for a surgicalstapling instrument, wherein the end effector is configured totransition between an open configuration and a closed configuration,wherein the end effector comprises: a staple cartridge, comprising: acartridge body including a proximal end portion and a distal endportion; an elongate slot extending from the proximal end portion to thedistal end portion; a deck surface, comprising: a firsttissue-compression surface; a second tissue-compression surfaceextending above the first tissue-compression surface; and a plurality offirst staple cavities arranged in a first row on a lateral side of theelongate slot, wherein the first row extends along the firsttissue-compression surface; and a plurality of second staple cavitiesarranged in a second row on the lateral side of the elongate slot,wherein the second row is closer to the elongate slot than the firstrow, and wherein the second row extends along the second tissue-compression surface; a set of staples, comprising: a first stapleremovably stored in the first row of staple cavities, wherein the firststaple comprises a first unformed height; and a second staple removablystored in the second row of staple cavities, wherein the second staplecomprises a second unformed height smaller than the first unformedheight; an anvil, comprising: an anvil tissue-compression surface; andstaple forming pockets defined in the anvil tissue-compression surface,wherein a first tissue gap is defined between the firsttissue-compression surface and the anvil tissue-compression surface whenthe end effector is in the closed configuration, wherein a second tissuegap is defined between the second tissue- compression surface and theanvil tissue-compression surface when the end effector is in the closedconfiguration, and wherein the second tissue gap is smaller than thefirst tissue gap; and a staple pusher system movable to simultaneouslydeploy the set of staples, wherein the staple pusher system comprises: afirst pusher member configured to lift the first staple into formingengagement with the anvil such that the first staple is formed to afirst fully-formed height; and a second pusher member configured to liftthe second staple into forming engagement with the anvil such that thesecond staple is formed to a second fully- formed height that is smallerthan the first fully-formed height.
 27. The end effector of claim 26,wherein the second staple is closer to the distal end portion than thefirst staple.
 28. The end effector of claim 27, wherein the secondpusher member is closer to the distal end portion than the first pushermember.
 29. The end effector of claim 26, wherein the staple cartridgeis replaceable with another staple cartridge.
 30. The end effector ofclaim 26, wherein the anvil tissue-compression surface comprises a firstportion and a second portion extending below the first portion towardthe staple cartridge.
 31. The end effector of claim 30, wherein thesecond portion of the anvil tissue-compression surface is closer to theelongate slot than the first portion.